Open Letter to Southwest Airlines
To the Leadership of Southwest Airlines,
Connective Truth is a public awareness project dedicated to changing how the world perceives lipedema and related conditions — not as a matter of healthcare alone, but as a matter of how people are seen, treated, and understood in everyday life. It is that second part, the everyday life part, that brings us to you.
There is an entire category of medical conditions that cause significant, progressive changes to body size and shape — conditions that have nothing to do with diet, willpower, or lifestyle. Lipedema. Lymphedema. Dercum's disease. Cushing's syndrome. And others. These are diagnosed, documented, often debilitating conditions that are also, to the untrained eye, completely indistinguishable from what a gate agent might simply read as overweight.
Airline employees are not clinicians, and no one expects them to be. They have not been trained in the presentation of these conditions, and they cannot reasonably be expected to distinguish between fat tissue deposited by a progressive connective tissue disease and fat tissue deposited by caloric surplus. What we are asking is that your policy acknowledge this limitation before placing that judgment call in their hands.
The psychological cost of these conditions is not incidental to this conversation. Patients with lipedema, lymphedema, and related disorders carry the weight of a medical reality that most people, including most medical providers, do not recognize or understand. They have often spent years being told their bodies are a personal failure. Being flagged at a gate, asked to purchase an additional seat, or quietly redirected by a stranger in a uniform is not a neutral transaction — it is a public confirmation of the most painful narrative these patients already carry. That harm is real, and your policy as currently designed makes your employees unwitting instruments of it.
We are also asking you to think forward. The Air Carrier Access Act prohibits discrimination on the basis of disability and requires carriers to consider reasonable accommodations. Conditions like lipedema are increasingly being recognized in medical and legal contexts as qualifying disabilities under this framework, and whether your customer of size policy, as applied, accounts for medically documented conditions is a question worth asking internally before someone else raises it externally.
We are not asking Southwest to absorb costs or abandon operational realities. We are asking for something more modest: that you train your staff to recognize the limits of what they can see, that you build a clear and dignified pathway for passengers with documented medical conditions, and that you consider whether a policy designed for one situation is being applied, without distinction, to an entirely different one.
The patients, advocates, providers, and allies signing this letter are not asking for special treatment. They are asking to be seen accurately, and that is a reasonable place to start.
Sincerely,
Wendy Moore
Executive Director, Connective Truth